Objective:To investigate and analyze the surgical method and therapeutic effect of removing benign masses between the nasal radix and eyebrow via a V-shaped cosmetic incision approach through the columella with the assistance of nasal endoscopy.Methods:The data of patients who underwent surgical treatment from May 2020 to August 2023 at the Department of Otorhinolaryngology, Head and Neck Surgery, Linyi People’s Hospital were retrospectively analyzed, because of a mass involving the radix of the nose and the interbrow area. Preoperative CT examination of the nose was performed to clarify the nature, size, and level of the mass, and a V-shaped incision was made in the middle and lower third of the nasal columella, with subcutaneous tunnels along the dorsal median line of the nose, and the mass was excised with the aid of nasal endoscopy. Postoperative follow-up was performed for recurrence of swelling, diplopia, ocular dyskinesia, frontal-facial numbness, and recovery of the operative area; patients were evaluated by visual analogue scoring (VAS) to assess satisfaction with the appearance of the incorporeal scar (0~10 points, higher scores indicate higher satisfaction).Results:A total of 4 patients were included, with an average age of 18.5 years (15-21 years). All 4 patients had complete resection of the tumor through the columellar V-shaped incision approach, and the surgical incisions were all healed by primary intention. Postoperative pathology suggested epidermoid cysts in 1 case, lipoma in 1 case, sebaceous cysts in 1 case, and osteomas in 1 case. Postoperative follow-up ranged from 6 to 24 months, with an average follow-up of 12 months, with no recurrence of the mass, no depression at the radix of the nose and between the eyebrows, and no noticeable scar at the columella. The patients were satisfied with the appearance of the incision scar with a VAS score of 10 points.Conclusion:Nasal endoscopic transnasal columella approach to excision of benign tumors at the root of the nose and between the eyebrows has the advantages of small skin incision and hidden scarring, and has good treatment effect.

ObjectiveTo investigate the mechanism of action of modified Shaofu Zhuyutang in antagonizing cellular pyroptosis and fibrosis in ectopic endometrial tissues of endometriosis through the Toll-like receptor 4/nuclear factor-κB/NOD-like receptor protein 3 （TRL4/NF-κB/NLPR3） signaling pathway. MethodsSeventy-two SPF-grade female SD rats were randomly divided into a sham-operated group （n = 12） and a modeling group （n = 60）. The rats in the sham-operated group underwent a caesarean section， while the rats in the modeling group were used to establish an endometriosis model through the auto-transplantation method. After successful modeling， the animals were randomly divided into the model group， progesterone group （0.25 mg·kg^-1）， and modified Shaofu Zhuyutang low-， medium-， and high-dose groups （7.5， 15， 30 g·kg^-1）， with 12 animals in each group. After 4 weeks of drug administration， voluntary activity and heat pain latency were observed. The rats were sacrificed for tissue collection， and Masson staining were used to observe histopathological changes in the endometrial tissues. Enzyme-linked immunosorbent assay （ELISA） was used to measure serum levels of interleukin-18 （IL-18）， interleukin-1β （IL-1β）， tumor necrosis factor-α （TNF-α）， and transforming growth factor-β （TGF-β）. Immunohistochemistry （IHC） was used to detect the protein expression area of tumor necrosis factor-related factor 6 （TRAF6） and NLPR3 in the endometrial tissues. Immunofluorescence （IF） was used to detect the relative fluorescence intensity of Caspase-1 and gasdermin D （GSDMD） in the endometrial tissues. Western blot was employed to measure the relative expression of TRL4， myeloid differentiation factor 88 （MyD88）， TRAF6， NF-κB p65， phosphorylated NF-κB p65 （p-NF-κB p65）， and NLPR3 proteins in endometrial tissues. Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR） was used to detect the mRNA expression of TRL4， MyD88， TRAF6， NF-κB， and NLPR3 in the endometrial tissues. ResultsCompared with the sham-operated group， rats in the model group showed reduced voluntary activity and shorter heat pain latency. Serum levels of IL-18， IL-1β， TNF-α， and TGF-β were elevated. The relative expression areas of TRAF6 and NLPR3 proteins were increased， and the relative fluorescence intensity of Caspase-1 and GSDMD was enhanced. The relative expression of TRL4， MyD88， TRAF6， NF-κB p65， p-NF-κB p65， and NLPR3 proteins， along with the expression of TRL4， MyD88， TRAF6， NF-κB， and NLPR3 mRNA， were significantly increased （P<0.01）. Compared with the model group， rats in the progesterone group and the modified Shaofu Zhuyutang medium- and high-dose groups exhibited improved voluntary activity， longer heat pain latency， the fibrosis of endometrial tissue is alleviated. Serum levels of IL-18， IL-1β， TNF-α， and TGF-β were decreased. The relative expression areas of TRAF6 and NLPR3 proteins decreased， and the relative fluorescence intensity of Caspase-1 and GSDMD weakened. The relative expression of TRL4， MyD88， TRAF6， p-NF-κB p65， NLPR3 proteins， and TRL4， MyD88， TRAF6， NF-κB， and NLPR3 mRNA expression were reduced （P<0.05， P<0.01）. ConclusionModified Shaofu Zhuyutang may play a therapeutic role in endometriosis by interfering with key proteins in the TRL4/NF-κB/NLPR3 signaling pathway， reducing NLRP3 inflammasome-induced cellular pyroptosis， antagonizing the fibrosis process in ectopic endometrial tissues， improving the inflammatory microenvironment in the pelvic cavity， and alleviating pain.

Objective:To investigate the impact of early invasive arterial blood pressure (IBP) monitoring on survival and neurological outcomes in out-of-hospital cardiac arrest (OHCA) patients undergoing extracorporeal cardiopulmonary resuscitation (ECPR).Methods:This retrospective cohort study analyzed 44 OHCA patients receiving ECPR between January 2021 and January 2023. Patients were divided into: Early intervention group : IBP established within 3 min of ECMO initiation; Late intervention group : IBP established after ICU admission. Baseline characteristics, ECMO parameters, and clinical outcomes were compared. Multivariable logistic regression (adjusted for age, initial rhythm, etc.) and Spearman's correlation were used.Results:This study included a total of 44 patients treated with OHCA and ECPR, divided into an early intervention group of 23 cases and a late intervention group of 21 cases. The early intervention group showed significantly higher: Survival to discharge (43.5% vs. 9.5%, P<0.05), Good neurological recovery (CPC 1-2: 34.8% vs. 9.5%, P<0.05).Early intervention independently predicted survival (adjusted OR=18.84, 95% CI:1.97-179.98, P=0.01). Stratified analysis by pH (cutoff 7.0) demonstrated consistent benefits in both pH>7.0 ( aOR=0.392, 95% CI:0.106-0.678) and pH≤7.0 subgroups ( aOR=0.385, 95% CI: 0.075-0.695; interaction P=0.183). Early IBP positively correlated with CPC scores ( ρ=0.40, P=0.007). Conclusions:Early IBP monitoring significantly improves survival and neurological outcomes in OHCA-ECPR patients, supporting its integration into standardized protocols.

Objective:To observe the effect of traditional Chinese medicine (TCM) hot ironing on limb function and balance ability in stroke patients with hemiplegia during the recovery period, and to provide more reference schemes for clinical rehabilitation of stroke patients with hemiplegia.Methods:A randomized controlled study was conducted. Stratified random sampling was used to select stroke patients with hemiplegia during the recovery period admitted to the First Affiliated Hospital of Anhui University of Chinese Medicine from June 2023 to January 2024. The patients were divided into a control group and an observation group using the random envelope method. The control group received limb positioning techniques combined with conventional acupuncture intervention, while the observation group received additional TCM hot ironing intervention. Before and after the intervention, the Brunnstrom motor function grading, three-level assessment method, and Activities of Daily Living (ADL) scale were used to evaluate the patients′ limb function, balance function, and daily living ability.Results:Among the 66 patients included, with 33 patients in the control group, includinng 19 males and 14 females, aged (51.02 ± 8.34) years old, and 33 patients in the observation group, including 21 males and 12 females, aged (49.65 ± 8.21) years old. Before the intervention, there were no statistically significant differences in Brunnstrom upper limb motor function, Brunnstrom lower limb motor function, sitting balance, standing balance, and ADL scores between the two groups (all P>0.05). After the intervention, the observation group showed significant improvements in Brunnstrom upper limb motor function (0 cases at levelⅠ, 33 cases at levelⅡor above), Brunnstrom lower limb motor function (1 case at levelsⅠ-Ⅲ, 32 cases at level Ⅳ or above), sitting balance (0 cases at levelsⅠ-Ⅱ, 33 cases at level Ⅲ), and standing balance (1 case at levelsⅠ-Ⅱ, 32 cases at level Ⅲ). The control group showed less improvement in Brunnstrom upper limb motor function (10 cases at levelⅠ, 23 cases at level Ⅱor above), Brunnstrom lower limb motor function (14 cases at levelsⅠ-Ⅲ, 19 cases at level Ⅳ or above), sitting balance (9 cases at levelsⅠ-Ⅱ, 24 cases at level Ⅲ), and standing balance (11 cases at levelsⅠ-Ⅱ, 22 cases at level Ⅲ). The differences between the two groups were statistically significant ( Z values were 9.39-15.51, all P<0.05). The ADL score in the observation group was (80.25 ± 8.89) points, higher than the control group′s score of (69.97 ± 8.17) points, the difference was statistically significant ( t=4.89, P<0.05). Conclusions:TCM hot ironing can effectively improve limb dysfunction, motor function, balance ability, and walking mobility in stroke patients with hemiplegia during the recovery period, thereby enhancing their daily living ability.

Objective:To explore potential categories of disease progression fear and self-management ability in patients with maintenance hemodialysis (MHD) and their influencing factors.Methods:Convenience sampling was used to select MHD patients in the Blood Purification Center of the Affiliated Nantong Hospital of Nanjing University of Chinese Medicine, the Affiliated Suzhou Hospital of Nanjing University Medical School, and the Affiliated Huaian First People's Hospital of Nanjing Medical University from November 2022 to May 2023 as study subjects. General Information Questionnaire, Fear of Progression Questionnaire-short form (FoP-Q-SF), Hemodialysis Self-management Instrument (HDSMI), and Perceived Social Support Scale (PSSS) were used to conduct the survey. Mplus 8.7 software was applied to conduct latent profile analysis, and multiple Logistic regression was used to explore the factors influencing the disease progression fear and self-management ability of different MHD patients.Results:A total of 380 questionnaires were distributed, and 364 valid questionnaires were recovered, with an effective recovery rate of 95.79%. The mean scores of FoP-Q-SF and HDSMI in 364 MHD patients were (2.53±0.84) and (2.81±0.54), respectively. MHD patients' fear of disease progression and self-management ability were manifested in three different potential categories, named high fear-general self-management (59.34%, 216/364), moderate fear-low self-management (24.45%, 89/364), and low fear-good self-management (16.21%, 59/364). Multiple Logistic regression showed that age, education level, marital status, comorbidities, duration on dialysis, and social support were influencing factors in the potential categories of fear of disease progression and self-management ability in MHD patients, and the difference was statistically significant ( P<0.05) . Conclusions:Healthcare professionals should give appropriate interventions to MHD patients with different types of fear of progression and self-management ability in order to reduce patients' fear of disease progression and improve their self-management ability.

Objective:To explore the trajectories of kinesiophobia in initial hemodialysis patients and their influencing factors.Methods:A convenience sampling method was used to recruit patients undergoing their first hemodialysis treatment at Hemodialysis Center, the Affiliated Huai'an No.1 People's Hospital of Nanjing Medical University from June to December 2023. Baseline data were collected using a general information questionnaire, the Tampa Scale for Kinesiophobia (TSK), the Dialysis Patient Symptom Burden Index (DFSSBI), the Fear of Progression Questionnaire-Short Form (FoP-Q-SF), the Multidimensional Fatigue Inventory (MFI-20), and the Pittsburgh Sleep Quality Index (PSQI). The TSK was used to measure kinesiophobia levels at 1, 3, and 6 months post-dialysis. Data were analyzed using a latent class growth mixture model, univariate analysis, and multinomial Logistic regression.Results:A total of 251 patients were surveyed, and 239 completed follow-ups. Three latent classes of kinesiophobia trajectories were identified: persistently high kinesiophobia group (32.22%, 77/239), moderate kinesiophobia-declining group (28.45%, 68/239), and persistently low kinesiophobia group (39.33%, 94/239). Multinomial Logistic regression analysis indicated that age, marital status, presence of sleep disorders, history of falls in the past year, symptom burden, fear of disease progression, and fatigue significantly influenced kinesiophobia trajectory classes ( P<0.05) . Conclusions:Kinesiophobia in initial hemodialysis patients exhibits distinct trajectories. Healthcare professionals should implement targeted interventions based on the influencing factors of kinesiophobia trajectory development.

Objective To explore the development trajectory and root cause of kinesiophobia in patients with diabetic peripheral neuropathy.Methods By the convenience sampling method,240 diabetic peripheral neuropathy patients who were hospitalized in the Department of Endocrinology of a tertiary A hospital in Jiangsu Province from May 2022 to November 2022 were selected.The baseline data of the patients are collected using a general questionnaire,the Tampa Scale for Kinesiophobia,the Chinese version of the Multidimensional Fatigue Inventory-20,the Pittsburgh Sleep Quality Index,the Social Support Rate Scale,and the Numerical Rating Scale for Pain.At the time of discharge,and at 3,6,and 12 months post-discharge,the level of kinesiophobia in the patients is assessed.The growth mixture model was used to classify the trajectory of kinesiophobia and analyze its root causes.Results Ultimately,227 patients in this study completed the survey.The trajectories of kinesiophobia in patients with diabetic peripheral neuropathy were divided into 3 latent classes:persistent high kinesiophobia group(22.5％),moderate kinesiophobia decline group(44.9％)and persistent low kinesiophobia group(32.6％).The results of multivariate Logistic regression analysis showed that age,frequency of hypoglycemia,complications,sleep quality,fall history within a year,pain and fatigue score were influencing factors of the latent classes of kinesiophobia trajectories in patients with DPN(P＜0.05).Conclusion Within 12 months after discharge,the kinesiophobia of patients with diabetic peripheral neuropathy shows population heterogeneity.Medical staff should give targeted interventions according to the developmental trajectories of kinesiophobia and root cause analysis.

Objective To explore the development trajectory and root cause of kinesiophobia in patients with diabetic peripheral neuropathy.Methods By the convenience sampling method,240 diabetic peripheral neuropathy patients who were hospitalized in the Department of Endocrinology of a tertiary A hospital in Jiangsu Province from May 2022 to November 2022 were selected.The baseline data of the patients are collected using a general questionnaire,the Tampa Scale for Kinesiophobia,the Chinese version of the Multidimensional Fatigue Inventory-20,the Pittsburgh Sleep Quality Index,the Social Support Rate Scale,and the Numerical Rating Scale for Pain.At the time of discharge,and at 3,6,and 12 months post-discharge,the level of kinesiophobia in the patients is assessed.The growth mixture model was used to classify the trajectory of kinesiophobia and analyze its root causes.Results Ultimately,227 patients in this study completed the survey.The trajectories of kinesiophobia in patients with diabetic peripheral neuropathy were divided into 3 latent classes:persistent high kinesiophobia group(22.5％),moderate kinesiophobia decline group(44.9％)and persistent low kinesiophobia group(32.6％).The results of multivariate Logistic regression analysis showed that age,frequency of hypoglycemia,complications,sleep quality,fall history within a year,pain and fatigue score were influencing factors of the latent classes of kinesiophobia trajectories in patients with DPN(P＜0.05).Conclusion Within 12 months after discharge,the kinesiophobia of patients with diabetic peripheral neuropathy shows population heterogeneity.Medical staff should give targeted interventions according to the developmental trajectories of kinesiophobia and root cause analysis.

Objective:To observe the effect of traditional Chinese medicine (TCM) hot ironing on limb function and balance ability in stroke patients with hemiplegia during the recovery period, and to provide more reference schemes for clinical rehabilitation of stroke patients with hemiplegia.Methods:A randomized controlled study was conducted. Stratified random sampling was used to select stroke patients with hemiplegia during the recovery period admitted to the First Affiliated Hospital of Anhui University of Chinese Medicine from June 2023 to January 2024. The patients were divided into a control group and an observation group using the random envelope method. The control group received limb positioning techniques combined with conventional acupuncture intervention, while the observation group received additional TCM hot ironing intervention. Before and after the intervention, the Brunnstrom motor function grading, three-level assessment method, and Activities of Daily Living (ADL) scale were used to evaluate the patients′ limb function, balance function, and daily living ability.Results:Among the 66 patients included, with 33 patients in the control group, includinng 19 males and 14 females, aged (51.02 ± 8.34) years old, and 33 patients in the observation group, including 21 males and 12 females, aged (49.65 ± 8.21) years old. Before the intervention, there were no statistically significant differences in Brunnstrom upper limb motor function, Brunnstrom lower limb motor function, sitting balance, standing balance, and ADL scores between the two groups (all P>0.05). After the intervention, the observation group showed significant improvements in Brunnstrom upper limb motor function (0 cases at levelⅠ, 33 cases at levelⅡor above), Brunnstrom lower limb motor function (1 case at levelsⅠ-Ⅲ, 32 cases at level Ⅳ or above), sitting balance (0 cases at levelsⅠ-Ⅱ, 33 cases at level Ⅲ), and standing balance (1 case at levelsⅠ-Ⅱ, 32 cases at level Ⅲ). The control group showed less improvement in Brunnstrom upper limb motor function (10 cases at levelⅠ, 23 cases at level Ⅱor above), Brunnstrom lower limb motor function (14 cases at levelsⅠ-Ⅲ, 19 cases at level Ⅳ or above), sitting balance (9 cases at levelsⅠ-Ⅱ, 24 cases at level Ⅲ), and standing balance (11 cases at levelsⅠ-Ⅱ, 22 cases at level Ⅲ). The differences between the two groups were statistically significant ( Z values were 9.39-15.51, all P<0.05). The ADL score in the observation group was (80.25 ± 8.89) points, higher than the control group′s score of (69.97 ± 8.17) points, the difference was statistically significant ( t=4.89, P<0.05). Conclusions:TCM hot ironing can effectively improve limb dysfunction, motor function, balance ability, and walking mobility in stroke patients with hemiplegia during the recovery period, thereby enhancing their daily living ability.

Objective:To explore potential categories of disease progression fear and self-management ability in patients with maintenance hemodialysis (MHD) and their influencing factors.Methods:Convenience sampling was used to select MHD patients in the Blood Purification Center of the Affiliated Nantong Hospital of Nanjing University of Chinese Medicine, the Affiliated Suzhou Hospital of Nanjing University Medical School, and the Affiliated Huaian First People's Hospital of Nanjing Medical University from November 2022 to May 2023 as study subjects. General Information Questionnaire, Fear of Progression Questionnaire-short form (FoP-Q-SF), Hemodialysis Self-management Instrument (HDSMI), and Perceived Social Support Scale (PSSS) were used to conduct the survey. Mplus 8.7 software was applied to conduct latent profile analysis, and multiple Logistic regression was used to explore the factors influencing the disease progression fear and self-management ability of different MHD patients.Results:A total of 380 questionnaires were distributed, and 364 valid questionnaires were recovered, with an effective recovery rate of 95.79%. The mean scores of FoP-Q-SF and HDSMI in 364 MHD patients were (2.53±0.84) and (2.81±0.54), respectively. MHD patients' fear of disease progression and self-management ability were manifested in three different potential categories, named high fear-general self-management (59.34%, 216/364), moderate fear-low self-management (24.45%, 89/364), and low fear-good self-management (16.21%, 59/364). Multiple Logistic regression showed that age, education level, marital status, comorbidities, duration on dialysis, and social support were influencing factors in the potential categories of fear of disease progression and self-management ability in MHD patients, and the difference was statistically significant ( P<0.05) . Conclusions:Healthcare professionals should give appropriate interventions to MHD patients with different types of fear of progression and self-management ability in order to reduce patients' fear of disease progression and improve their self-management ability.